Provider Demographics
NPI:1023635877
Name:OHWOBETE, EMU GODSPOWER
Entity type:Individual
Prefix:
First Name:EMU
Middle Name:GODSPOWER
Last Name:OHWOBETE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 ASPINWOOD WAY APT E
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-4210
Mailing Address - Country:US
Mailing Address - Phone:443-500-2458
Mailing Address - Fax:
Practice Address - Street 1:1 CLEMENTINE CT APT 3B
Practice Address - Street 2:
Practice Address - City:ROSEDALE
Practice Address - State:MD
Practice Address - Zip Code:21237-6999
Practice Address - Country:US
Practice Address - Phone:443-500-2458
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-28
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR219657363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health